Crncević-Orlić Zeljka, Ruzić Alen, Miletić Bojan, Petrović Oleg, Zaputović Luka, Kehler Tatjana, Racki Sanjin, Kapović Miljenko
Department of Internal Medicine, University Hospital Rijeka, Rijeka, Croatia.
Coll Antropol. 2007 Sep;31(3):771-4.
Gestational diabetes mellitus is a carbohydrate intolerance recognized in pregnancy. The objective of this study was to determine the prevalence of gestational diabetes mellitus (GDM) of all deliveries at the University Hospital Rijeka, Croatia (34 997 deliveries over 10-year period) using 2-hour 75 g oral glucose tolerant test and to evaluate the impact of GDM on neonatal outcomes and mother's health. Gestational diabetes was diagnosed in 55 of 128 pregnant women with suspected glucose intolerance. Logistic regression analysis was used to examine the relationship between fasting plasma glucose, age, family history, body mass index, maternal weight gain, neonatal weight, neonatal head diameter and Apgar score in the gestational diabetes group and in the non-diabetes group. The results indicate that fasting plasma glucose greater than 7.0 mmol/L and maternal overweight are strong predictors for GDM and macrosomia. There was no difference in the mode of delivery, and vitality and metabolic complications among the infants of all analyzed mothers. We concluded that to prevent GDM as well as to reduce the rate of macrosomic infants good glycemic control should be initiated as soon as possible. The 2-hour 75 g OGTT is worth enough to evaluate GDM. Women should be counseled and encouraged to lose weight before or at the beginning of the conception period.
妊娠期糖尿病是孕期出现的一种碳水化合物不耐受情况。本研究的目的是采用2小时75克口服葡萄糖耐量试验,确定克罗地亚里耶卡大学医院所有分娩中的妊娠期糖尿病(GDM)患病率(10年期间共34997例分娩),并评估GDM对新生儿结局和母亲健康的影响。128例疑似葡萄糖不耐受的孕妇中有55例被诊断为妊娠期糖尿病。采用逻辑回归分析来检验妊娠期糖尿病组和非糖尿病组中空腹血糖、年龄、家族史、体重指数、孕妇体重增加、新生儿体重、新生儿头径和阿氏评分之间的关系。结果表明,空腹血糖大于7.0 mmol/L和孕妇超重是GDM和巨大儿的强预测因素。所有分析母亲的婴儿在分娩方式、活力和代谢并发症方面没有差异。我们得出结论,为预防GDM以及降低巨大儿发生率,应尽早开始良好的血糖控制。2小时75克口服葡萄糖耐量试验足以评估GDM。应建议并鼓励女性在受孕前或受孕初期减肥。